VMDiva

Musings of a Veterinarian
Subscribe

Archive for January 23rd, 2015

What I Wish My Clients Knew

January 23, 2015 By: Dr. K Category: Opinion

Publishing this post has weighed on my shoulders. I’ve made the mistake of perusing the web, dangerously reading the opinions of lay people who lambast modern medicine and veterinarians. It’s crushing – but mostly – really irritating. Time to say what’s on my mind.

1. I am not rich.

I am in debt. Yep. That’s right. Like nearly all veterinary graduates who completed school circa the millennium or after, I carry a heavy student loan burden. Every month I have the equivalent of a big mortgage direct-debited from my checking account. It’s best this way so I don’t have to look at the money rapidly draining out of my funds. And with tax season upon us, I just received the balances remaining on my loans. It’s nauseating.

I am not sure where the misconception that veterinarians are rich comes from but suspect it’s from a lack of understanding of business practice and the laws of overhead and employment cost. Clients sometimes only see the “big” bill at the end of the visit and must erroneously believe the veterinarian pockets that money. By the time operational, supply, and staff costs are covered there’s not a lot leftover. Believe me.

2. While I may not be monetarily rich, I am rich in spirit…most days.

Veterinary medicine is fun, engaging, and ever-changing. There’s rarely a dull moment and that’s one of the things I love most about my career. A successful case keeps me walking on clouds for the day.  It’s a passion, a lifestyle, and a way to make a living. But it has a dark side the general public does not see. This career sucks the life out of you. Not in a boring-sitting-in-a-cubicle way. No.

It’s far more insidious.

Death, suffering, long hours, and high expectations are an elephant sitting on our chests. Clients can be demanding and demeaning without being compliant or trusting. In the height of stress, grief, and guilt, owners can say some of the unkindest things you can imagine. My shoulders are broad and most days I handle it well. But occasionally I bring it home with me and the queasy feeling lingers for weeks.

On the most challenging days I may come to your exam room after euthanizing a favorite patient and getting berated on the phone by a disgruntled client. Perhaps I’ve just been accused of “stealing food from a child’s mouth” or preventing someone from buying his ailing spouse’s prescriptions with my “high costs” of treatments and medications. Maybe I just found out a colleague committed suicide, succumbing to the depression that creeps in over years of burnout.

I walk in to your appointment with a smile, hiding the sorrow and the hurt from the previous appointments. While you may be my 15th appointment of the day, your 20 minutes with me is your only impression and I have to put a smile on my face. I need to make you feel like your cat is the most special cat in the world and answer questions I have answered a million times before without bleating like a broken record. If you walk out of your appointment knowing I love your pet, I have done my job well. I take pride in that.

3. Your opinion matters…most times.

Veterinarians share the basic need of feeling “liked”. I want you to like and respect me both as a person and a veterinarian. I want you to appreciate how much I care about the well-being of your pet. Please come again. Perhaps that sounds trite, but I strive to please my clients by being kind, accommodating, and understanding.

But….

When you get angry with me because I won’t authorize a refill of your animal’s prescription when we haven’t seen your pet for three years and you’ve refused to keep up with the required lab work? No – at that point your opinion of me does NOT matter.

As my head hits my pillow at night, I need to rest assured I made decisions that upheld the standard of care I have set for your dogs. I need to know I have advocated for your cat. I need to know I’m not killing your dog with Rimadyl or Heartgard. If a client is angry I won’t practice below the standard of care to accommodate their demands, I will happily agree to provide a copy of her records and challenge her to find another veterinarian.

Side Note: The fastest way to get fired from my veterinary practice is to treat my staff with disrespect. Clients will never get away with name-calling, screaming, and stomping their feet.

4. I am not perfect and I hate it.

Most veterinarians are Type-A personalities. Perfectionists by nature, we push ourselves and oftentimes become our own worst critics.  Like any other medical professional, I cannot get the answer right every time. It kills me. I want to be able to streamline the diagnostic and treatment process for my clients. I don’t want to spend clients’ money and not get answers.

It’s called the “practice of medicine” for a reason. We’re always fine-tuning and perfecting our craft. That means missed diagnoses. It means imperfect surgeries and complications. It might mean more serious errors that could even lead to an animal’s death.  The terrifying stakes make me neurotic about preventing errors.

I’m not a perfect vet. I can never be perfect. And that keeps me up at night.

5. Euthanasia is NOT the hardest thing I do.

So many times, in the saddest moments of ending an animal’s life, my clients tearfully utter that this – this act of euthanizing dear pets – must be the hardest thing I ever have to do. I offer a conciliatory agreement to a grieving owner but the truth is it’s not even remotely the most difficult thing I do in the scope of my job.

Ninety-nine percent of the time the animal presented for euthanasia is suffering. Cancer, organ failure, or debilitating arthritis all lead to a confident decision euthanasia is the best course. Perhaps I have compartmentalized and protected my heart with this approach, but I truly believe I make the biggest difference by relieving suffering. Euthanasia is less a burden and more a gift to my patient.

The hardest thing I deal with is client finances. So often I am forced to make economic medical decisions because clients cannot afford the prescribed work-up and treatment plan. I loathe discussing estimates because so many times I receive negative reactions to the cost of diagnostics, treatments, and follow-up. I am stuck between two difficult spots: Providing the optimal treatment for my patient versus practicing within the financial limitations of my client. I cannot give away services routinely and stay in business. I must pay my overhead, staff, and myself. Yet, the compassion and drive to heal that provoked me to pursue veterinary medicine make me feel angst over allowing economics to play a role in my practice.

There’s no solution to this problem. Rare is the vet who doesn’t give away services. But if I gave away services to every case that needed charity, I would quickly be out of business. See #1.

6. I don’t want my child to become a vet.

Most parents would be flattered if they discovered their child wanted to follow in their footsteps. I’d get a knot in my stomach.

I want better for my daughter. She doesn’t need the physical abuse veterinary medicine rages on our bodies. She must live without a lifetime of debt. I don’t want anyone to question her integrity because they mistakenly believe she’s greedy. She doesn’t need to stay up at night worrying about her cases. Why enter a field where the public’s respect and trust is declining? And I cannot stand idly while she joins colleagues with one of the highest suicide rates of all professionals.

Please, dear child, get a business degree.